As you may have noticed, Road to Hellth posts have been few and far between since the re-election of President Obama in 2012. One important reason is that we started this blog in an attempt to highlight various landmarks that American Medicine is passing on its way to mediocrity, or much, much worse. Perhaps naively, we had hoped that our fellow citizens might want to think twice about taking this road if they could clearly see where it going to lead. After all, who could imagine that the average person would want to pay more for worse care, while having faceless unelected bureaucrats who get better benefits and healthcare than you do arbitrarily making gazillions of rules about what care and services you must or could not have and when?
The re-election of the President changed all of that. Not only did the American electorate reaffirm its desire to “finish the job” (as Mr. Obama put it in one of his debates with Mitt Romney), but they quite clearly rejected the notion that the President and his executive branch were even accountable for their actions.
Whether it’s handing federally funded guns to drug runners in a “fast and furious” way, or billions of taxpayer dollars to politically connected but subsidy dependent “green” companies such as Solyndra, or attributing the September 11th killings in Benghazi to spontaneous demonstrations against an Internet video, or selectively and arbitrarily deciding which words and phrases of which parts of which laws it wanted to enforce or ignore – the underlying message of the President’s re-election was that process no longer matters; and for that matter neither did the results. The electoral majority of Americans are either too ignorant, or too helpless, or too discouraged, or too self-absorbed to resent a previously unimaginable level of waste, fraud and abuse carried out in the name of “progress”, “fairness”, “equity” or some other term rendered meaningless as the new feel-good buzzword of the day. (Most chillingly, these quintessentially unquantifiable terms are now most frequently used to assign a sense of guilt and blame to whoever might happen to disagree with policies carried out in their name. But that’s another story.)
The clearly incompetent implementation of ObamaCare itself is perhaps the best single example of the listlessness that has overtaken a nation that used to pride itself for its efficiency, effectiveness and lack of corruption. Corruption? Yes, corruption. For the way in which our elected and appointed officials are conducting the public’s business has become well and truly unhealthy; broken and despoiled by those entrusted with it.
Corruption; mid-14c., from Old French corropt “unhealthy, corrupt; uncouth” (of language), and directly from Latin corruptus, past participle of corrumpere “to destroy; spoil,” figuratively “corrupt, seduce, bribe,” from com-, intensive prefix (see com-), + rup-, past participle stem of rumpere “to break” (see rupture (n.)). Related: Corruptly; corruptness.
Let’s just take a single example: Oregon’s ObamaCare insurance exchange – the one called “Cover Oregon”.
The experience of Cover Oregon is a microcosm of the ObamaCare exchange efforts in general. Months before its putative roll-out date of October 1st, Cover Oregon began a $21 million psychedelic ad campaign designed to do something, but nobody seemed to know exactly what. (A liberal Oregon street tabloid (Ed. note: Is there any other kind?), The Portland Mercury, described them as “twee”.) Here’s just one example:
To live in Oregon over the past six months is to have been bombarded with these types of commercials for Cover Oregon at every turn – on television, the radio, billboards and in print ads. Mind you, this is for a state that has only 3.5 million people, of whom 560,000 were uninsured in 2011 and another 600,000 were already enrolled in Medicaid.
And how has the Cover Oregon rollout gone? Well as of the last day of 2013, Cover Oregon’s defective website has not been able to enroll a single person. Not one. As of December 2013, this amazing performance has cost over $160 million and counting. Luckily, there are far more of your tax dollars to spend: the federal government awarded Oregon $226 million to set the whole exchange up.
In response, Oregon’s elected officials and their political appointees pulled out all the stops. A full two months after the website’s scheduled launch date, Cover Oregon Executive Director Rocky King announced that he was going on medical leave and might or might not return. Two and one-half months after the blown launch Carolyn Lawson, the state technology guru in charge of the website’s development announced that she was resigning from her $178,992 a year position for “personal reasons”, which presumably included getting as far away from blame for her professional handiwork as possible.
As an article in the The Oregonian newspaper explained at the time of her resignation:
An August 2012 report from the project’s quality assurance contractor found the exchange project was disorganized, lacked basic management and budget controls to ensure contractor performance. The exchange’s fate was further endangered by distrust and lack of communication between Lawson’s Oregon Health Authority and Cover Oregon, the public corporation that took over responsibility for the exchange’s contracts in May 2013.
As recently as last week, Lawson defended the choice of Oracle and the decision not to hire a systems integrator. The exchange was built with Oracle software and hardware, so who better than Oracle to manage the process, she said.
“The reason why you want a prime is you want to have access to the people who know the most about the platform or platforms you’re using,” Lawson said. “We had Oracle.”
Lawson worked closely with Oracle when she worked for two California state agencies before her hiring by Oregon. She was a featured speaker at OpenWorld, Oracle’s enormous annual technology trade show, in 2012 and 2013, she confirmed. She received no compensation for doing so, she said.
Tina Edlund, acting OHA director, sent out an email shortly after 2 p.m. Thursday announcing Lawson’s departure. In an email to her bosses, Lawson said the recent death of her mother-in-law convinced her to make the move. She’d been commuting to Oregon weekly from her home in the Sacramento area.
“We want to thank Carolyn for her service to our agencies and the state,” Edlund said in the email. “Under her leadership, the OIS team had many successes and improved services to both OHA/DHS employees and the citizens of Oregon.”
Lawson handed control of the exchange in May to Rocky King, Cover Oregon’s executive director. Longtime OHA leader Bruce Goldberg became acting Cover Oregon director earlier this month after King went on medical leave. Goldberg has taken over daily oversight of the troubled exchange project.
Officials in Gov. John Kitzhaber’s office declined comment on Lawson’s departure. The governor has called for an independent review of the exchange technology development effort and how it went wrong.
The state is negotiating with a contractor it wants to conduct the review. “We’re still determining the scope,” said Kitzhaber spokesman Ian Greenfield. “We’re moving as fast as we can on getting this started.
So let’s get this straight: this state employee, who is not even an Oregon resident and apparently has business ties to the software contractor involved, completely blows the management of the Cover Oregon website and over $160 million in taxpayer dollars and you want to “thank her for her service”?
Running out of people to thanks and congratulate, the state then did the only logical thing: it decided to spend yet more money in order to enroll people using horribly-unfashionable-but-utterly-reliable paper application forms. The state spent $4 million to hire 400 new employees to process paper forms. They’re paid between $14 and $17 per hour, but ironically don’t get health benefits.
Unfortunately even those efforts have not been enough to fix this fiasco. On December 21st, Cover Oregon essentially told uninsured Oregonians trying to submit paper applications that “if you haven’t heard from us by the Monday before Christmas, you’re screwed”.
Oregon’s troubled health insurance exchange began robocalling applicants Friday, warning them that if they don’t receive enrollment confirmation by Monday, they should seek coverage elsewhere for Jan. 1.
“If you haven’t heard from us by Dec. 23, it is unlikely your application will be processed for Jan. 1 insurance coverage,” a woman’s voice on the pre-recorded call from Cover Oregon says. “If you want to be sure you have insurance coverage starting Jan. 1, you have other options.”
It’s yet another sign that the health insurance exchange’s technological breakdowns will prevent some — perhaps many — Oregonians from getting subsidized coverage Jan. 1, despite Gov. John Kitzhaber’s previous assurances otherwise. Out of more than 65,000 applicants, the exchange reports enrolling nearly 30,000, but only about 11,000 of them in private insurance plans.
The calls also suggest the exchange’s problems will prevent many of those individuals from receiving tax credits or subsidies in January, even though they qualify for them.
Cover Oregon spokesman Michael Cox said Friday he did not know how many recorded calls were being made. They targeted individuals whose eligibility for tax credits has not been determined, Cox said, including those with incorrect applications.
So the Cover Oregon spokesperson doesn’t even know how many calls it’s making to potentially affected individuals? Does anyone there know anything?
In response, the state extended the sign-up deadline by one week more than the extensions allowed by the Obama administration. Then, with one hour left in that deadline, extended the application deadline yet again to January 6th, 2014, with coverage retroactive to January 1st. Presumably the state’s insurers will be left covering the cost of benefits (but no premiums) received in the interim.
And oh yes, one more thing. After spending $8 million on ads to get people to sign up for Cover Oregon insurance even though the state had literally no way to process their applications in a timely fashion, the state finally decided to temporarily “suspend” those twee Cover Oregon ads on the day after Christmas.
But here’s the real point. After all of this spending – over $2,600 for each and every Cover Oregon applicant – not one single government employee has been held responsible in any way. No one has been fired. No one has been disciplined. In fact, no one appears to have even discussed firing or disciplining anyone for blowing over fifty cents of tax dollars for every man, woman and child in the United States with almost nothing whatsoever to show for it. When it comes to the government and what it does to the American healthcare system, results and costs don’t matter. There is no accountability, nor is any offered by those in power. In Boston on October 31st, President Obama took “full responsibility” for the defective rollout of the federally operated ObamaCare exchange website. But not a single head has rolled over that debacle either. In fact, as far as we know no one even received a gentle reprimand. If so it certainly never made it into the mass media.
One might be able to excuse such behavior in our leaders if there was even the slightest shred of evidence that they had done their best, or indeed that they even cared in the slightest. There is supposedly some disagreement about whether President Obama has ever actually ever met one-on-one with Health and Human Services Secretary Kathleen Sebelius since the passage of the ObamaCare law:
“The Health and Human Services (HHS) Department on Friday claimed that HHS Secretary Kathleen Sebelius meets frequently with President Barack Obama and just had a meeting with him on Thursday, one day after a report by the nonpartisan Government Accountability Institute revealed that Obama and Sebelius have not had a one-on-one meeting since Obamacare passed.
That was the only specific date that either HHS or the White House mentioned while claiming Sebelius and Obama “regularly” meet.
The Health and Human Services Department released a statement indicating that Sebelius “has been to the White House countless times since becoming Secretary.”
“She is frequently at the White House for meetings related to the implementation of the Affordable Care Act, including dozens with the President in the last year alone. In fact, she met with the President just yesterday,” an HHS spokesperson said.
On Friday, White House Press Secretary also claimed that Obama “regularly” meets with Sebelius and that cabinet secretaries do not get frequently entered into the visitors logs.
As Breitbart News Senior Editor-at-Large and Government Accountability Institute President Peter Schweizer noted on Fox News’s Hannity on Wednesday, though, GAI examined the White House visitor logs and found that whenever Sebelius went to the White House, it was for social functions with “dozens or hundreds of people.” He noted on Hannity that if Obama met with Sebelius and left the meetings off the books, Sebelius would be the only cabinet secretary whose meetings with the White House were concealed.
The Government Accountability Institute report found that since Obamacare was signed on March 23, 2010, Obama met with “various Cabinet secretaries a total of 277 times,” but his presidential schedule did not “document a single one-on-one meeting” with Sebelius. There was, though, “one instance of Secretary Sebelius meeting jointly with the President and Secretary of the Treasury Timothy Geithner.”
In response, Time magazine’s Swampland claimed that Sebelius met with Obama “a lot” in undocumented meetings, while simultaneously reporting that the HHS Secretary admitted that “the President was never told the launch of HealthCare.gov was destined to flop”. Which brings us back to exactly the same question of exactly who the heck have we got running healthcare in this country? If they met so frequently, did the President really never, ever, bother to ask her, “Hey Kathleen, so how is this ObamaCare thing coming along?” Who on Earth is that incurious? Or are we supposed to believe that he cared enough to ask her, but she either lied to him or refused to tell him? If so, shouldn’t she have been the first one fired as the President vowed to accept full “responsibility”?
Here’s the point. What exactly does it mean to have our elected and appointed leaders “responsible”, but clearly not in any way accountable? Governing the regulation and delivery of healthcare is hardly some trivial or abstract thing; we’re talking about people’s lives here. Screwing it up on a routine basis inevitably means that some of us – perhaps even you or beloved members of your family – will literally die as a result of this level of incompetence. Yet the profound lack of accountability means that NOTHING will change for those in charge when it happens.
What a difference a year makes. Hellth in America is now closer than ever. If anything, the pace of our slide into the abyss will accelerate with the expanding reach of ObamaCare in 2014.